Respiratory physiotherapy and analgesia to prevent pulmonary complications after rib fractures: A narrative review
DOI:
https://doi.org/10.62827/fb.v27i8.1285Keywords:
Thoracic Injuries; Breathing Exercises; Early Ambulation; Rib Fractures; Pneumonia.Abstract
Introduction: Rib fractures may restrict inspiration, coughing, and mobility and promote atelectasis, secretion retention, pneumonia, and respiratory failure. Objective: To analyse the integration of respiratory physiotherapy and pain control in preventing pulmonary complications in adults with traumatic rib fractures. Methods: A narrative review searched the Medical Literature Analysis and Retrieval System Online and the Physiotherapy Evidence Database, with the last update completed on 17 September 2026. The searches identified 301 records and 262 after deduplication; 27 publications comprised the synthesis. Studies of adults with rib fractures or blunt chest trauma were included. Appraisal considered design, directness, consistency, precision, and source-reported limitations, without formal certainty grading. Results: Evidence supports serial assessment, education, lung expansion, supported coughing, positioning, and early mobilisation, although many recommendations derive from consensus and observational studies. Incentive spirometry yielded conflicting results. Regional techniques reduced pain and opioid use, but their effects on pneumonia and mortality remained uncertain. Integrated protocols were associated with fewer complications and shorter hospital stay. Conclusion: Current evidence favours integrating multimodal analgesia, physiotherapy, mobilisation, and objective reassessment; however, observational associations do not demonstrate a causal effect of the care bundle, and each component's independent contribution requires pragmatic trials.
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Copyright (c) 2026 Rafael Viana dos Santos Coutinho, Igor Parada Marangoni, Bárbara Junqueira Carvalho Coutinho, Victor Augusto Sebben, Kamila Lima Rocha (Autor)
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